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出 处:《中国癌症杂志》2014年第2期157-160,共4页China Oncology
摘 要:背景与目的:调强放疗(intensity modulated radiation therapy,IMRT)是在最大限度提高肿瘤靶区照射剂量的同时明显减少周围正常组织剂量的放疗技术,化疗是防止远处转移的有效手段。本文旨在观察IMRT同步化疗治疗中晚期食管癌的临床效果。方法:将62例中晚期食管癌患者分为两组,其中同步放化疗组(IMRT+化疗)32例,单纯放疗组(单纯IMRT)30例。两组患者均采用IMRT放疗,同步放化疗组同期采用化疗方案TP(紫杉醇175mg/m^2,第1天;奈达铂,30mg/m^2,第1-3天),化疗28d为1个周期,至少化疗2个周期。比较两组近期临床疗效及不良反应。结论:同步放化疗组有效率(CR+PR)为93.8%,高于单纯放疗组的76.7%,差异有统计学意义(P〈O.05),同步放化疗组的l、2年局控率(84.4%、59.4%)高于单纯放疗组(70.0%、36.7%),差异有统计学意义(P〈O.05);两组的生存率差异无统计学意义(P〉O.05);同步放化疗组白细胞下降和放射性食管炎发生率以及Ⅲ、Ⅳ级不良反应发生率均明显高于单纯放疗组(P〈O.05)。Background and purpose: Intensity-modulated radiation therapy (IMRT) enables the delivery of higher radiation dose to the primary tumor target, while sparing the organs and tissues at risk (OARs). Chemotherapy is an effective means to prevent distant metastasis. The purpose of this study was to observe clinical effect of concurrent intensity-modulated radiation therapy and chemotherapy for advanced esophageal carcinoma. Methods: A total number of 62 cases of advanced esophageal carcinoma were divided into two groups. There were 32 cases in concurrent chemoradiotherapy group, and 30 cases were in radiotherapy alone group. The patients in two groups were both used IMRT radiotherapy, while the patients of concurrent chemoradiotherapy group were plused adjuvant chemotherapy. The chemotherapy regimen was TP. Twenty-eight days was a treatment cycle, 2 treatment cycles were lasted during chemoradiotherapy.After that, recent curative effect and toxicside reaction were compared between two groups. Results: The total relief rate (CR+PR) in concurrent chemoradiotherapy group was 93.8%. The total relief rate in radiotherapy alone group was 76.7%. There were significant differences between the two groups (P〈0.05). One-year local response rate(84.4%) and 2-year local response rate (59.4%) in concurrent chemoradiotherapy group were both higher than those (70.0%, 36.7%) in radiotherapy alone group (P〈0.05), while the survival rate was similar between the two groups (P〉0.05). Toxicside reaction in concurrent chemoradiotherapy group, including leucocytes decrease, radioactive esophagitis and Ill, IV toxicity, were higher than those in radiotherapy alone group (P〈0.05). Conclusion: After treating advanced esophageal carcinoma with concurrent intensity-modulated radiation therapy and chemotherapy, the recent curative effect and the local response were fine, while toxicity was more serious.
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